Middletown Branch of Touro College of Osteopathic Medicine

[JGimpel]

Not sure if this is old news already:

http://www.osteopathic.org/inside-a...-receives-permission-to-begin-operations.aspx

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[hallowmann]

Yeah, its a branch for like 100 new students, but uts essentially just an extension of Touro-NY, so it doesn't really have a separate administration.

Chalk it up to yet another school expansion.

 

[Postictal Raiden]

Yeah, its a branch for like 100 new students, but uts essentially just an extension of Touro-NY, so it doesn't really have a separate administration.

Chalk it up to yet another school expansion.

With the addition of 100 more students, the total first-year enrollment for DO schools will be close to 6600 next year. That's nearly a 22% increase over the past 4 years. If this trend continues then by 2020 the total first-year enrollment will be over 8200, 4 times the number of AOA residency positions.

 

[Drrrrrr. Celty]

With the addition of 100 more students, the total first-year enrollment for DO schools will be close to 6600 next year. That's nearly a 22% increase over the past 4 years. If this trend continues then by 2020 the total first-year enrollment will be over 8200, 4 times the number of AOA residency positions.

It'll be the era of attending schools simply for having first dibs at opti.

 

[user3]

also OU-HCOM's Columbus extension campus will be 50 students, and LUCOM will be 162. Touro-Middletown class size will be 135.

Number of matriculants for Fall 2013 was 6,449. For Fall 2014 it will be around 6,800

 

[Seth Joo]

With the addition of 100 more students, the total first-year enrollment for DO schools will be close to 6600 next year. That's nearly a 22% increase over the past 4 years. If this trend continues then by 2020 the total first-year enrollment will be over 8200, 4 times the number of AOA residency positions.

This kind of rapid increase in enrollment is not a good sign. There will probably be a situation in the future where students will not have residency training positions when they graduate.

The AOA could not care less either.

 

[Setto]

I got accepted to Touro Middletown. It is significantly nicer than Touro-Harlem! I don't mind the increased expansion so long as the schools aren't crap.

I wouldn't be too afraid of residency positions in the near future however things will start to get a bit tough in 10 or so years. The only thing the AOA can do to cover their insane expansion would be to merge with the MDs!

 

[happypremed1]

I got accepted to Touro Middletown. It is significantly nicer than Touro-Harlem! I don't mind the increased expansion so long as the schools aren't crap.

I wouldn't be too afraid of residency positions in the near future however things will start to get a bit tough in 10 or so years. The only thing the AOA can do to cover their insane expansion would be to merge with the MDs!

If they want to expand rapidly, then there's no way AOA would want to merge with AMA, who has much higher standard for establishing a medical school. It seems to me that COCA will grant provisional accreditation to recruit students and faculty members for anyone who has a nice building and some theoretical rotation spots.

Going at this expansion rate, by 2020, the average DO students will be happy to match into any residency, let alone the residency of their choice. The below-average DO students will have no place to go. Of course, I'm assuming that Congress doesn't do anything to open more slots.

 

[user3]

COCA actually now requires schools to "strive" to place 100% of students in Gme positions, and requires a minimum of 98% placement averaged over 3 years

 

[Setto]

If they want to expand rapidly, then there's no way AOA would want to merge with AMA, who has much higher standard for establishing a medical school. It seems to me that COCA will grant provisional accreditation to recruit students and faculty members for anyone who has a nice building and some theoretical rotation spots.

Going at this expansion rate, by 2020, the average DO students will be happy to match into any residency, let alone the residency of their choice. The below-average DO students will have no place to go. Of course, I'm assuming that Congress doesn't do anything to open more slots.

I just figured that they will encourage more and more DO to enter ACGME match because there won't be any other alternative. Once they support the match, why not merge?

As for 2020, lack of GME won't be an issue for DO alone. Fleets and fleets of DO are entering residencies and the work force. The amount of DOs will never surpass MDs but they will become more common by the year. It would not be surprising to see many more DO residency PDs out and about by 2020 (in US and Canada). Eventually it won't matter what some guy who thought up your medical philosophy believed, board score and electives will be all that matter.

Edit: there's also always the option of Canada for GME. (though it's a bit trickier for you Americans)

 

[Igor4sugry]

This kind of rapid increase in enrollment is not a good sign. There will probably be a situation in the future where students will not have residency training positions when they graduate.

The AOA could not care less either.

That is already happening. There are MDs going unmatched more and more each year. I'm not sure if there are #s for this on DOs.
This will continue to squeeze out MDs from their residencies as more DOs apply (many of them very good applicants).

 

[happypremed1]

so what happens to the students that got their degrees from a new school that lost accreditation? They can't recruit students anymore? This doesn't really help since they had already "dumped" 3

I just figured that they will encourage more and more DO to enter ACGME match because there won't be any other alternative. Once they support the match, why not merge?

As for 2020, lack of GME won't be an issue for DO alone. Fleets and fleets of DO are entering residencies and the work force. The amount of DOs will never surpass MDs but they will become more common by the year. It would not be surprising to see many more DO residency PDs out and about by 2020 (in US and Canada). Eventually it won't matter what some guy who thought up your medical philosophy believed, board score and electives will be all that matter.

Edit: there's also always the option of Canada for GME. (though it's a bit trickier for you Americans)

There is a concurrent expansion on the MD side, albeit at a slower pace. Last time I check, the proposal to increase residency spots was stopped in the House.

 

[Seth Joo]

That is already happening. There are MDs going unmatched more and more each year. I'm not sure if there are #s for this on DOs.
This will continue to squeeze out MDs from their residencies as more DOs apply (many of them very good applicants).

Some MDs do go unmatched but I think DOs will wind up getting the short end of the stick, the rapid growth of new schools and bigger class sizes is far faster than the growth for MD schools.

The AOA nor the schools could care about students.

 

[Setto]

The AOA nor the schools could care about students.

Not sure I agree with the latter. Any medical school on North American soil is invested in their students. Rapid expansion may give the impression of degree mills but repeat business is the name of the game. Many would head down to the Caribbean if they cared enough about their students to ensure they all graduate and get residencies. Great weather and caring faculty! But that's not the case...

 

[Setto]

so what happens to the students that got their degrees from a new school that lost accreditation? They can't recruit students anymore? This doesn't really help since they had already "dumped" 3

Good question! It seems like a policy like what was mentioned above would leave a lot of students shyte out of luck. Even if the AOA were to say the school could no longer recruit until they get their act together, having the name of an institution that was shut down on your resume could potentially destroy your odds of landing a decent residency.

 

[Seth Joo]

Not sure I agree with the latter. Any medical school on North American soil is invested in their students. Rapid expansion may give the impression of degree mills but repeat business is the name of the game. Many would head down to the Caribbean if they cared enough about their students to ensure they all graduate and get residencies. Great weather and caring faculty! But that's not the case...

The Caribbean schools are already for profit machines, but the direction of AOA schools is going in the direction of diploma mills. I have not heard of Allopathic schools building multiple campuses around the country. Two Allopathic schools have campuses in foreign countries, Cornell has one in Qatar, and Duke has a school in Singapore, those schools were built to serve those respective countries.

The AOA does not care about students, and the schools themselves will only help students so as much as they make themselves look good. There are many examples of graduate programs failing their students. Law school is an example, many law school graduates are having a hard time finding employment, mostly because there are too many law schools. There could be a point in the future where there might be too many DO schools. DOs have for a long time been mostly Primary Care physicians, in recent years you see them in all fields of medicine and in academia. I think things might change if too many schools open.

 

[TheWeeIceMan]

That is already happening. There are MDs going unmatched more and more each year. I'm not sure if there are #s for this on DOs.
This will continue to squeeze out MDs from their residencies as more DOs apply (many of them very good applicants).

You think DO students are pushing MD students out of their residency spots?

 

[Seth Joo]

I got accepted to Touro Middletown. It is significantly nicer than Touro-Harlem! I don't mind the increased expansion so long as the schools aren't crap.

I wouldn't be too afraid of residency positions in the near future however things will start to get a bit tough in 10 or so years. The only thing the AOA can do to cover their insane expansion would be to merge with the MDs!

That is something they do not want to do. What I see happening is that DO schools will become like Law and Business schools, people who go to the more prestigious programs will have better career prospects.

 

[user3]

That is something they do not want to do. What I see happening is that DO schools will become like Law and Business schools, people who go to the more prestigious programs will have better career prospects.

But a problem with that is a lot of the better DO schools like TCOM and MSU are practically off limits for out of state applicants.

 

[darklabel]

Here is a list of schools in Applicant Status: http://www.osteopathic.org/inside-aoa/accreditation/predoctoral accreditation/Documents/new-and-developing-colleges-of-osteopathic-medicine-and-campuses.pdf

Realize that a rapid growth in schools will be a huge negative and a step back from how much ground DOs have covered in the ACGME. If ACGME programs begin getting flooded with DO applicants and since the number of MD applicants is also increasing, an easy way for residents and staff to get through applications is just barring DO students or making some kind of ridiculous standards. I promise this will definitely affect even the top applicants and most certainly the average applicant. I know it sounds "doom and gloom", but this is a real possibility within the next decade if this keeps up.

Also, I know we're all special snowflakes, but being a top DO student that can rise above their MD counterparts significantly (such as much higher Step 1 scores and not just a couple points above the average) is easier said than done.

The incompetence of the AOA and COCA never seizes to amaze me. I also enjoy how each new DO school and site starts with an absurd amount of students. 162 opening class for LU? Really? And it has nothing to do with tuition dollars but for that PCP shortage?

EDIT: Just realized they also want to open more for profit schools, such as Larkin COM in Miami, FL even though South FL has 4 medical schools in the area already...ridiculous
http://www.bizjournals.com/southflorida/news/2013/04/23/larkin-hospital-closes-48-acre.html?page=all

 

[Setto]

You think DO students are pushing MD students out of their residency spots?

It's happening. Many programs will take a great DO over an average MD. I'm not saying the MD doesn't match anywhere but being an MD doesn't suddenly mean you have first dibs on ACGME res anymore.

 

[user3]

Here is a list of schools in Applicant Status: http://www.osteopathic.org/inside-aoa/accreditation/predoctoral accreditation/Documents/new-and-developing-colleges-of-osteopathic-medicine-and-campuses.pdf

Realize that a rapid growth in schools will be a huge negative and a step back from how much ground DOs have covered in the ACGME. If ACGME programs begin getting flooded with DO applicants and since the number of MD applicants is also increasing, an easy way for residents and staff to get through applications is just barring DO students or making some kind of ridiculous standards. I promise this will definitely affect even the top applicants and most certainly the average applicant. I know it sounds "doom and gloom", but this is a real possibility within the next decade if this keeps up.

Also, I know we're all special snowflakes, but being a top DO student that can rise above their MD counterparts significantly (such as much higher Step 1 scores and not just a couple points above the average) is easier said than done.

The incompetence of the AOA and COCA never seizes to amaze me. I also enjoy how each new DO school and site starts with an absurd amount of students. 162 opening class for LU? Really? And it has nothing to do with tuition dollars but for that PCP shortage?

EDIT: Just realized they also want to open more for profit schools, such as Larkin COM in Miami, FL even though South FL has 4 medical schools in the area already...ridiculous
http://www.bizjournals.com/southflorida/news/2013/04/23/larkin-hospital-closes-48-acre.html?page=all

DO schools are tuition driven (main source of revenue) and new schools unfortunately require these large class sizes to cover their expenses.

 

[TheWeeIceMan]

It's happening. Many programs will take a great DO over an average MD. I'm not saying the MD doesn't match anywhere but being an MD doesn't suddenly mean you have first dibs on ACGME res anymore.

Anything to back this up or are you just pulling stuff directly out of your butt? Sounds like someone has been drinking dat A.T. Still Kool-Aid.

 

[NontradCA]

also OU-HCOM's Columbus extension campus will be 50 students, and LUCOM will be 162. Touro-Middletown class size will be 135.

Number of matriculants for Fall 2013 was 6,449. For Fall 2014 it will be around 6,800

OUHCOM does have the residencies and rotations for its students though.

 

[touchpause13]

The additional schools don't bother me, but the lack of residency spots to go along with them is bad news. It's unfortunate that the bill that proposed GME expansion went no where. Although i suppose expecting the govt to make things easier for doctors is overly optimistic on my part

 

[Drrrrrr. Celty]

The additional schools don't bother me, but the lack of residency spots to go along with them is bad news. It's unfortunate that the bill that proposed GME expansion went no where. Although i suppose expecting the govt to make things easier for doctors is overly optimistic on my part

Personally I'm ok with the limited amount of residencies. The last thing we need is an over saturation of doctors killing our employment and salary prospects.
I mean call me crude but the idea of being stuck with a poor salary or being unemployed after dropping 240-280k( pending no debt from undergrad) is not sweet in any regard.

 

[Postictal Raiden]

I'm wondering if the point of this expansion is, aside from making money, to take over what the Caribbean schools have been doing for the last few decades.

 

[touchpause13]

I guess I'm worried about both over saturation and DOs not matching. So idk

 

[Postictal Raiden]

I guess I'm worried about both over saturation and DOs not matching. So idk

I don't think there's much to worry about. Take a look at the data on this site http://www.nrmp.org/match-data/main-residency-match-data/. The number of pgy-1 positions offered last year was over 26k while in the year 2000 the number was 20k. In the past 13 years, the number of MD residency slots grew by 6000, regardless of the cap that exists. I don't have a source that shows how many DO slots were added during the same time frame.

Besides, you will be going to one of the oldest, more known DO programs. Just do well in you school and on your boards and you will be fine. Those who attend new schools are taking a larger risk, however. But that risk is still significantly lower than the one taken by those who choose to go the Caribbean.

 

[Elevencents]

Use this as motivation. Do well on your boards and shine in your clinical years and none of this will matter.

 

[darklabel]

I don't think there's much to worry about. Take a look at the data on this site http://www.nrmp.org/match-data/main-residency-match-data/. The number of pgy-1 positions offered last year was over 26k while in the year 2000 the number was 20k. In the past 13 years, the number of MD residency slots grew by 6000, regardless of the cap that exists. I don't have a source that shows how many DO slots were added during the same time frame.

Besides, you will be going to one of the oldest, more known DO programs. Just do well in you school and on your boards and you will be fine. Those who attend new schools are taking a larger risk, however. But that risk is still significantly lower than the one taken by those who choose to go the Caribbean.

I know we're fine and the next few classes will still be ok. But I fear for future classes. Looking 10 years out, these schools opening up worry me since every school opens with a ridiculous amount of people per class. Most MD schools start with a small class like 40 while DO schools start out with a ridiculous amount of students their first year without at least testing the waters with a small class.

Also, have you seen that list of applicant schools? Honestly, some of those schools are either for-profit or small Christian schools, none of them being strong programs or even state schools. The expansion would be a much more positive thing if these schools were at least somewhere known and respectable. We need more schools like OU and MSU and not more schools like LU or another Tuoro branch.

 

[Drrrrrr. Celty]

I know we're fine and the next few classes will still be ok. But I fear for future classes. Looking 10 years out, these schools opening up worry me since every school opens with a ridiculous amount of people per class. Most MD schools start with a small class like 40 while DO schools start out with a ridiculous amount of students their first year without at least testing the waters with a small class.

Also, have you seen that list of applicant schools? Honestly, some of those schools are either for-profit or small Christian schools, none of them being strong programs or even state schools. The expansion would be a much more positive thing if these schools were at least somewhere known and respectable. We need more schools like OU and MSU and not more schools like LU or another Tuoro branch.

Again, until the dinosaurs are evicted and a new generation of D.Os replace them we will continue to have these issues. I mean even the board of trustees at this point thinks that the AOA/COCA are full of **** and is harming the reputation of those they're supposedly representing. I still believe fully that the best outcome in all of this will be to give the LCME/ACGME the reigns in accrediting all of the medical schools and residencies in the nation and even then it's pretty obvious they didn't care to remove or end this ridiculous notion of osteopathic distinctiveness so the old guard have nothing to fear. The only losers in this situation would be those who stood to profit from the existence of a distinct board.

Either way the start and biggest battle for the defense of our education will not come from limiting osteopathic schools, but by merging residency accrediatory organizations. After that happens we can begin to erode away and bargain for other things to change.

 

[Postictal Raiden]

I know we're fine and the next few classes will still be ok. But I fear for future classes. Looking 10 years out, these schools opening up worry me since every school opens with a ridiculous amount of people per class. Most MD schools start with a small class like 40 while DO schools start out with a ridiculous amount of students their first year without at least testing the waters with a small class.

Also, have you seen that list of applicant schools? Honestly, some of those schools are either for-profit or small Christian schools, none of them being strong programs or even state schools. The expansion would be a much more positive thing if these schools were at least somewhere known and respectable. We need more schools like OU and MSU and not more schools like LU or another Tuoro branch.

I agree with you. COCA needs to be more selective with their accreditation. However, I still see that there's room for expansion. Looking at the match results, 6600 positions went to IMG's and FMG's, more than 3x the number of positions given to DO grads. Despite how bad a for-profit or a Christian DO school may seem, I still think that it is a better alternative than going Carib "diploma mills" and medical school overseas. Take a look at Marian, for example. Their admission stats are higher than some of the more established DO schools.

Bottom line, I'm for DO school expansion if the point of it is to replace the supply of IMG's and FMG's.

 

[Postictal Raiden]

Again, until the dinosaurs are evicted and a new generation of D.Os replace them we will continue to have these issues. I mean even the board of trustees at this point thinks that the AOA/COCA are full of **** and is harming the reputation of those they're supposedly representing. I still believe fully that the best outcome in all of this will be to give the LCME/ACGME the reigns in accrediting all of the medical schools and residencies in the nation and even then it's pretty obvious they didn't care to remove or end this ridiculous notion of osteopathic distinctiveness so the old guard have nothing to fear. The only losers in this situation would be those who stood to profit from the existence of a distinct board.

Either way the start and biggest battle for the defense of our education will not come from limiting osteopathic schools, but by merging residency accrediatory organizations. After that happens we can begin to erode away and bargain for other things to change.

IMO, the only way a unified match will be beneficial is if the whole stigma associated with the DO degree disappears, and that is something than may not happen in our lifetime. Otherwise, DO grads will still be at a disadvantage when applying to residency positions at big academic programs. The separate matches serve to insulate DO's from competing against MD's over the more desired specialties. If this barrier is eliminated, I can see many of those positions going to MD grads. There are more MD's than DO's and it is more statistically probable that these former DO Derm/ENT/Uro/Ortho/Neursrg/Ophtho positions will be occupied by MD grads.

 

[Drrrrrr. Celty]

IMO, the only way a unified match will be beneficial is if the whole stigma associated with the DO degree disappears, and that is something than may not happen in our lifetime. Otherwise, DO grads will still be at a disadvantage when applying to residency positions at big academic programs. The separate matches serve to insulate DO's from competing against MD's over the more desired specialties. If this barrier is eliminated, I can see many of those positions going to MD grads. There are more MD's than DO's and it is more statistically probable that these former DO Derm/ENT/Uro/Ortho/Neursrg/Ophtho positions will be occupied by MD grads.

Not at all, there will undoubtedly be insulation and favoring of DOs in former AOA programs. In the end we need ACGME accreditation as it is our way of legitimizing our education if our medical schools and medical education is for some reason called into question ( this is also another reason why we should be all taking the USMLE).

 

[Postictal Raiden]

Not at all, there will undoubtedly be insulation and favoring of DOs in former AOA programs. In the end we need ACGME accreditation as it is our way of legitimizing our education if our medical schools and medical education is for some reason called into question ( this is also another reason why we should be all taking the USMLE).

I see what you are saying. As of now, I think a dual accredited residency is the way to go, and I have been noticing that there is a trend of converting the DO residencies into dual accredited ones. If fact, most if not all newly added programs are dual accredited. Take a look by clicking onto each program http://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx

 

[Drrrrrr. Celty]

I see what you are saying. As of now, I think a dual accredited residency is the way to go, and I have been noticing that there is a trend of converting the DO residencies into dual accredited ones. If fact, most if not all newly added programs are dual accredited. Take a look by clicking onto each program http://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx

Which is wonderful for a lot of reasons. Either way, what I'm saying is that once the match is unified we can move on to unifying other aspects and bartering with the AOA.

 

[Postictal Raiden]

Which is wonderful for a lot of reasons. Either way, what I'm saying is that once the match is unified we can move on to unifying other aspects and bartering with the AOA.

Well, from what I have read, it seems that the unification is going to happen sooner or later. A lot of things could change from now till we graduate in 2018. Meanwhile, we should strive to be among the top 10%, or at least among the top half, so if sh_t hits the fan we will be fine.

 

[hallowmann]

Here is a list of schools in Applicant Status: http://www.osteopathic.org/inside-aoa/accreditation/predoctoral accreditation/Documents/new-and-developing-colleges-of-osteopathic-medicine-and-campuses.pdf

....

The incompetence of the AOA and COCA never seizes to amaze me. I also enjoy how each new DO school and site starts with an absurd amount of students. 162 opening class for LU? Really? And it has nothing to do with tuition dollars but for that PCP shortage?

EDIT: Just realized they also want to open more for profit schools, such as Larkin COM in Miami, FL even though South FL has 4 medical schools in the area already...ridiculous
http://www.bizjournals.com/southflorida/news/2013/04/23/larkin-hospital-closes-48-acre.html?page=all

Its crazy to think that a little over a decade ago, there were only 4 FL med schools. Now its more than twice that. They don't need any more.

To be realistic though, look at that list of applicant schools again. A couple haven't applied since 2008 (when the economy wasn't half bad), and 4 others haven't applied for a few years. My guess is any school that hasn't submitted an application in the last 2 years, is unlikely to get established any time soon. I mean honestly, MUCOM, ACOM, & CUSOM all submitted their apps in 2010 and were established by 2013, so any school taking much longer than that is just testing the waters. It takes virtually nothing to submit an app for starting a new DO school. Its literally something like $500 (maybe less) and a few pieces of paper.

That said, to get pre-accreditation status is a much harder thing. The fact that there are no schools in the pre-accreditation box means to me things are finally slowing down, something that hasn't happened in years now.

Also, I think COCA is at least moving in the right direction with its new OGME requirements for new and current schools, and honestly, I wouldn't be surprised if that made schools that were looking to set up degree mills are taking a step back.

It's happening. Many programs will take a great DO over an average MD. I'm not saying the MD doesn't match anywhere but being an MD doesn't suddenly mean you have first dibs on ACGME res anymore.

As much as I'd like that to be the case (as a DO student), it isn't. Being an MD does mean you have first dibs on ACGME spots. I mean you even implied it in your post by saying "many programs will take a great DO over an average MD" (which may or may not be true depending on the specialty). If MDs didn't have first dibs at ACGME spots, then a slightly above average DO would get picked over an average MD.

In any case, great DOs have more ACGME opportunity now than any time before, but I doubt we are anywhere close to US MDs not having first dibs on ACGME residencies.

DO schools are tuition driven (main source of revenue) and new schools unfortunately require these large class sizes to cover their expenses.

Almost all private schools (whether DO or MD) are tuition driven...

Personally I'm ok with the limited amount of residencies. The last thing we need is an over saturation of doctors killing our employment and salary prospects.
I mean call me crude but the idea of being stuck with a poor salary or being unemployed after dropping 240-280k( pending no debt from undergrad) is not sweet in any regard.

We're not close to having too many docs. Sure maybe in certain areas there is an over saturation, but across the country, we're not even close. Add on the millions that will have health insurance come January, and we'll be in a bit of a hole. So much so that other healthcare professionals (NPs and PAs) are trying to make hospitals believe they are the cheaper alternative to physicians in order to "fill the deficits".

Sure not everyone wants to live in the middle of nowhere, but many areas within 1-2 hrs of big cities are hurting for docs. There will always be demand for physicians in the foreseeable future, the issue now is about expanding smartly and incentivising primary care and shortage areas.

 

[Postictal Raiden]

Its crazy to think that a little over a decade ago, there were only 4 FL med schools. Now its more than twice that. They don't need any more.

To be realistic though, look at that list of applicant schools again. A couple haven't applied since 2008 (when the economy wasn't half bad), and 4 others haven't applied for a few years. My guess is any school that hasn't submitted an application in the last 2 years, is unlikely to get established any time soon. I mean honestly, MUCOM, ACOM, & CUSOM all submitted their apps in 2010 and were established by 2013, so any school taking much longer than that is just testing the waters. It takes virtually nothing to submit an app for starting a new DO school. Its literally something like $500 (maybe less) and a few pieces of paper.

That said, to get pre-accreditation status is a much harder thing. The fact that there are no schools in the pre-accreditation box means to me things are finally slowing down, something that hasn't happened in years now.

Also, I think COCA is at least moving in the right direction with its new OGME requirements for new and current schools, and honestly, I wouldn't be surprised if that made schools that were looking to set up degree mills are taking a step back.



As much as I'd like that to be the case (as a DO student), it isn't. Being an MD does mean you have first dibs on ACGME spots. I mean you even implied it in your post by saying "many programs will take a great DO over an average MD" (which may or may not be true depending on the specialty). If MDs didn't have first dibs at ACGME spots, then a slightly above average DO would get picked over an average MD.

In any case, great DOs have more ACGME opportunity now than any time before, but I doubt we are anywhere close to US MDs not having first dibs on ACGME residencies.



Almost all private schools (whether DO or MD) are tuition driven...



We're not close to having too many docs. Sure maybe in certain areas there is an over saturation, but across the country, we're not even close. Add on the millions that will have health insurance come January, and we'll be in a bit of a hole. So much so that other healthcare professionals (NPs and PAs) are trying to make hospitals believe they are the cheaper alternative to physicians in order to "fill the deficits".

Sure not everyone wants to live in the middle of nowhere, but many areas within 1-2 hrs of big cities are hurting for docs. There will always be demand for physicians in the foreseeable future, the issue now is about expanding smartly and incentivising primary care and shortage areas.

+1

Although the ratio of number of physicians to number of population is greater than it has ever been (we have double the number of doctors today we had in 1970), there are reasons while a severe shortage is expected to take place in the near future. Reasons such as: 1) half doctors are over the age of 50 and will be retiring within the next 15 years 2) the addition of tens of millions of newly insured patients 3) doctors don't work nearly as many hours as they used to (I read a study that shows doctors today work 10% less hours than they did couple decades ago) 4) We have more female physicians than we ever had. More maternity leave and early retirement (sorry to sound sexist).

PC medicine will suffer the most because of this shortage. It is hard to convince medical students to pursue FM knowing that they could be making double the salary by pursuing other specialties like Gas and EM.

 

[Drrrrrr. Celty]

+1

Although the ratio of number of physicians to number of population is greater than it has ever been (we have double the number of doctors today we had in 1970), there are reasons while a severe shortage is expected to take place in the near future. Reasons such as: 1) half doctors are over the age of 50 and will be retiring within the next 15 years 2) the addition of tens of millions of newly insured patients 3) doctors don't work nearly as many hours as they used to (I read a study that shows doctors today work 10% less hours than they did couple decades ago) 4) We have more female physicians than we ever had. More maternity leave and early retirement (sorry to sound sexist).

PC medicine will suffer the most because of this shortage. It is hard to convince medical students to pursue FM knowing that they could be making double the salary by pursuing other specialties like Gas and EM.

I think fundamentally the main issue is that for many people the lifestyle, the patient base, and what the career entail is what stops them from pursuing FM. If people were happy with the career and what they could do with it then people would go into it more. I mean see for example psychiatry. The money you can make working similar hours to other doctors is probably as much as EM, it has no call, and a terribly unfilled field. But in the end people don't choose it because they don't feel happy in it or content with the practice.

 

[darklabel]

Some solid reasoning Hallowmann

PC medicine will suffer the most because of this shortage. It is hard to convince medical students to pursue FM knowing that they could be making double the salary by pursuing other specialties like Gas and EM.

Yeah, as much as I enjoy the idea of FM (though haven't even started med school yet so my likes can change), the other specialties are beginning to look like great choices. I currently have ~40k of debt from undergrad and grad school and will probably tack on an additional ~200k for medical school. Add in interest and my debt load becomes quite high. Definitely will have to see where I stand in the future.

But that is a discussion for another thread. Now that no schools are in Pre-Accred, it will lessen the load of DO students; however, the idea of opening new satellite programs needs to end.

 

[Postictal Raiden]

I think fundamentally the main issue is that for many people the lifestyle, the patient base, and what the career entail is what stops them from pursuing FM. If people were happy with the career and what they could do with it then people would go into it more. I mean see for example psychiatry. The money you can make working similar hours to other doctors is probably as much as EM, it has no call, and a terribly unfilled field. But in the end people don't choose it because they don't feel happy in it or content with the practice.

I agree with you to some extent. However, believe me, if tomorrow CMS decides to double primary care reimbursement and cut that of colonoscopy by half, you will be surprised how competitive FM will be while many GI fellowships will go unfilled.

 

[Postictal Raiden]

Some solid reasoning Hallowmann



Yeah, as much as I enjoy the idea of FM (though haven't even started med school yet so my likes can change), the other specialties are beginning to look like great choices. I currently have ~40k of debt from undergrad and grad school and will probably tack on an additional ~200k for medical school. Add in interest and my debt load becomes quite high. Definitely will have to see where I stand in the future.

But that is a discussion for another thread. Now that no schools are in Pre-Accred, it will lessen the load of DO students; however, the idea of opening new satellite programs needs to end.

Same here. I have 60K+ in undergrad loans and will add another 300K+ in med school loans, totaling ~450K of debt after interests. As much as I love to be a "doctor for all", I won't turn down an opportunity to specialize in something that could double my income.

 

[Igor4sugry]

Here is a list of schools in Applicant Status: http://www.osteopathic.org/inside-aoa/accreditation/predoctoral accreditation/Documents/new-and-developing-colleges-of-osteopathic-medicine-and-campuses.pdf

Realize that a rapid growth in schools will be a huge negative and a step back from how much ground DOs have covered in the ACGME. If ACGME programs begin getting flooded with DO applicants and since the number of MD applicants is also increasing, an easy way for residents and staff to get through applications is just barring DO students or making some kind of ridiculous standards. I promise this will definitely affect even the top applicants and most certainly the average applicant. I know it sounds "doom and gloom", but this is a real possibility within the next decade if this keeps up.

I don't think this will happen. If anything the FMGs and IMGs will be squezed out. DO student are very good and PDs would rather thake a DO grad since they know what they are getting than FMG or IMG.

 

[bajastapler]

I support DO expansion; HOWEVER, we need to see an emphasis on OGME expansion x9000

 

[Setto]

Anything to back this up or are you just pulling stuff directly out of your butt? Sounds like someone has been drinking dat A.T. Still Kool-Aid.

sadly only anecdotal (from friends who have been through the process.) No Kool-aid over here, I just feel like a physician is a physician is a physician.

 

[Setto]

Its crazy to think that a little over a decade ago, there were only 4 FL med schools. Now its more than twice that. They don't need any more.

To be realistic though, look at that list of applicant schools again. A couple haven't applied since 2008 (when the economy wasn't half bad), and 4 others haven't applied for a few years. My guess is any school that hasn't submitted an application in the last 2 years, is unlikely to get established any time soon. I mean honestly, MUCOM, ACOM, & CUSOM all submitted their apps in 2010 and were established by 2013, so any school taking much longer than that is just testing the waters. It takes virtually nothing to submit an app for starting a new DO school. Its literally something like $500 (maybe less) and a few pieces of paper.

That said, to get pre-accreditation status is a much harder thing. The fact that there are no schools in the pre-accreditation box means to me things are finally slowing down, something that hasn't happened in years now.

Also, I think COCA is at least moving in the right direction with its new OGME requirements for new and current schools, and honestly, I wouldn't be surprised if that made schools that were looking to set up degree mills are taking a step back.



As much as I'd like that to be the case (as a DO student), it isn't. Being an MD does mean you have first dibs on ACGME spots. I mean you even implied it in your post by saying "many programs will take a great DO over an average MD" (which may or may not be true depending on the specialty). If MDs didn't have first dibs at ACGME spots, then a slightly above average DO would get picked over an average MD.

In any case, great DOs have more ACGME opportunity now than any time before, but I doubt we are anywhere close to US MDs not having first dibs on ACGME residencies.



Almost all private schools (whether DO or MD) are tuition driven...



We're not close to having too many docs. Sure maybe in certain areas there is an over saturation, but across the country, we're not even close. Add on the millions that will have health insurance come January, and we'll be in a bit of a hole. So much so that other healthcare professionals (NPs and PAs) are trying to make hospitals believe they are the cheaper alternative to physicians in order to "fill the deficits".

Sure not everyone wants to live in the middle of nowhere, but many areas within 1-2 hrs of big cities are hurting for docs. There will always be demand for physicians in the foreseeable future, the issue now is about expanding smartly and incentivising primary care and shortage areas.

Oups, I didnt make myself clear. I meant it in the sense that it's not like they wait for all MDs to match and then start interviewing a second wave of FMG, IMG and DOs.

Edit: I know I only responded to the portion of text that was directed at me, but just wanted you to know that you make some very good and valid points!

 

[hallowmann]

I don't think this will happen. If anything the FMGs and IMGs will be squezed out. DO student are very good and PDs would rather thake a DO grad since they know what they are getting than FMG or IMG.

DOs are definitely preferred over IMGs, but the expansion without appropriate GME expansion will hurt us overall. Thd IMGs and FMGs might feel the pain first and the most, but more US MD/DO graduates means more competition for spots and most likely more DOs being forced into AOA programs they don't really want or even more DOs ending up only in TRIs and having to struggle through the match again.

Oups, I didnt make myself clear. I meant it in the sense that it's not like they wait for all MDs to match and then start interviewing a second wave of FMG, IMG and DOs.

Edit: I know I only responded to the portion of text that was directed at me, but just wanted you to know that you make some very good and valid points!

Thats true, its not a clearcut ordered priority. I think the real problem will be the general increase in the nunber of good (or even average) MD graduates as well as good DO graduates competing for the same number of spots as they are now.

 

[user3]

DOs are definitely preferred over IMGs, but the expansion without appropriate GME expansion will hurt us overall. Thd IMGs and FMGs might feel the pain first and the most, but more US MD/DO graduates means more competition for spots and most likely more DOs being forced into AOA programs they don't really want or even more DOs ending up only in TRIs and having to struggle through the match again.



Thats true, its not a clearcut ordered priority. I think the real problem will be the general increase in the nunber of good (or even average) MD graduates as well as good DO graduates competing for the same number of spots as they are now.

I remember cliquesh (CCOM grad) saying that in his class, only a minority took the USMLE and he only knew of a fraction that did well (230+) on it.

Do you really think that all the 22-24 mcat applicants that'll be filling spots at new schools like LUCOM will be acing the usmle? I'm not saying that metrics have the greatest correlation with board scores, but all these new schools will hardly be filling with the cream of the crop.

I think US MD expansion will hurt DO students the most